CMSA Today - Issue 1, 2016 - (Page 10)
Carolinas HealthCare System's
Carolinas Medical Center and
Crisis Assistance Ministries
BY KATHRYN HARRELL, MSW, ACM
ince one of our hospital's goals is to
reduce readmissions, like most hospitals,
we look not only at patients' medical
needs, but their non-medical needs as well,
because socioeconomic factors influence a
patient's health. Housing, transportation,
social support, primary language, income, and
access to resources are just a few factors case
managers consider when assessing patients
for things in which they may need assistance
when they leave the hospital.
We often wish we could remove all of the
problems that a patient may present, but
we do not have the time or the expertise
to navigate every county, state, or federal
system effectively. So we focus on the factors
that we do have knowledge about, like
medication assistance, and cross our fingers
that the patients follow up with the referrals
and packets of information provided to help
address their other problems. Unfortunately,
this strategy works only some of the time.
Therefore, our department has partnered with
a well-known community organization to assist
patients with resources we do not have.
This organization, Crisis Assistance Ministry,
uses a statewide online tool that screens lowincome residents for nutritional, health, and
financial benefits for which they are eligible
under existing state and federal programs.
There are millions of dollars in benefits that are
not being used simply because individuals do
not know they are eligible for benefits.
Although the online tool assists individuals
with many benefits, in implementing this
resource our team decided to focus on
supplemental food and nutrition services. We
thought that if patients had more financial
assistance for food, they might be better able
to afford their medications. Case managers
often meet with patients who have trouble
affording their medication, even if they have
prescription coverage, and therefore skip doses
or end up not taking their medication at all.
This is often a factor to their readmission to
the hospital. These patients are quickly labeled
Issue 1 * 2016 * DIGITAL
as non-compliant by practitioners, but this
usually is not an accurate or fair label, as a
patient may have chosen between spending
money on food versus buying medications.
What Is Food Insecurity?
Two studies have found that older adults in
particular may have to choose between food
and medications because they cannot afford
both.1 It is not surprising these two may affect
one another when "...one in six Americans
reported that they lack health insurance...
and nearly one in five said they had trouble
meeting basic needs.2 A cross-sectional analysis
was conducted2 of the adult National Health
Interview Survey, focusing on two variables: "...
cost-related medication underuse, which refers
to taking less medication than prescribed, or
not taking it at all, due to cost" and "...food
insecurity, defined as limited or uncertain
availability of nutritionally adequate and safe
foods, or limited or uncertain ability to acquire
acceptable foods in socially acceptable ways.3
Table of Contents for the Digital Edition of CMSA Today - Issue 1, 2016
CMSA CORPORATE PARTNERS
Discharge Planning Regulations
INDEX OF ADVERTISERS
CMSA Today - Issue 1, 2016